Abstract
Objective: To report the outcome of adult spinal deformity (ASD) in patients with rod fracture (RF) after thoracolumbar fusion. Methods: Retrospective review of prospective, multicenter database. Operative patients with ASD ≥18 years old with RF after ASD surgery and with a minimum 6-month follow-up after RF were included. Health-related quality of life scores and radiographic alignment were compared with nonparametric paired and independent testing (P < 0.05). Results: A total of 51 of 343 patients with ASD (14.9%) sustained a RF, of whom 44 (86.3%) had at least 6-month follow up after RF (mean age = 61.2 years, mean body mass index = 29.6 kg/m2). Mean total follow-up was 37.8 months (range 24.5-66.7 months). Interbody fusion was used in 26 cases of RF (59.1%) (transforaminal lumbar interbody fusion, n = 17 [65.4%], anterior lumbar interbody fusion, n = 5 [19.2%]). RF was symptomatic in 26 of 44 (59.1%) of patients and discovered incidentally in 18 of 44 patients (40.9%). Overall, 28 RFs were revised (63.6%); 12 of 23 (52.2%) unilateral RF and 16 of 21 (76.2%) bilateral RF at last follow-up. Revision patients were significantly more likely to be symptomatic at the time of RF detection (78.6% vs. 25.0%, P = 0.0006), and had significantly worse Oswestry Disability Index and Scoliosis Research Society-22r pain scores. Conclusions: RFs were detected in 14.9% of patients with ASD and were most common at the L4-L5 and L5-S1 levels. Approximately 63.6% of patients underwent revision surgery. The decision to perform revision surgery may be based predominantly on symptoms referable to the RF, pain, and perceived disability, as radiographic parameters at the time of RF did not differ significantly between patients who did and did not undergo revision.
| Original language | English (US) |
|---|---|
| Journal | World Neurosurgery |
| DOIs | |
| State | Accepted/In press - 2017 |
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Keywords
- Adult spinal deformity
- Health-related quality of life
- Oswestry Disability Index
- Pedicle subtraction osteotomy
- Revision
- Rod fracture
ASJC Scopus subject areas
- Surgery
- Clinical Neurology
Cite this
The Fate of Patients with Adult Spinal Deformity Incurring Rod Fracture After Thoracolumbar Fusion. / Hamilton, D. Kojo; Buza, John A.; Passias, Peter; Jalai, Cyrus; Kim, Han Jo; Ailon, Tamir; Gupta, Munish; Sciubba, Daniel; Jain, Amit; Ames, Christopher P.; Deviren, Vedat; Daniels, Alan; Lafage, Virginie; Bess, Shay; Klineberg, Eric Otto; Shaffrey, Christopher I.; Smith, Justin S.; Hart, Robert.
In: World Neurosurgery, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The Fate of Patients with Adult Spinal Deformity Incurring Rod Fracture After Thoracolumbar Fusion
AU - Hamilton, D. Kojo
AU - Buza, John A.
AU - Passias, Peter
AU - Jalai, Cyrus
AU - Kim, Han Jo
AU - Ailon, Tamir
AU - Gupta, Munish
AU - Sciubba, Daniel
AU - Jain, Amit
AU - Ames, Christopher P.
AU - Deviren, Vedat
AU - Daniels, Alan
AU - Lafage, Virginie
AU - Bess, Shay
AU - Klineberg, Eric Otto
AU - Shaffrey, Christopher I.
AU - Smith, Justin S.
AU - Hart, Robert
PY - 2017
Y1 - 2017
N2 - Objective: To report the outcome of adult spinal deformity (ASD) in patients with rod fracture (RF) after thoracolumbar fusion. Methods: Retrospective review of prospective, multicenter database. Operative patients with ASD ≥18 years old with RF after ASD surgery and with a minimum 6-month follow-up after RF were included. Health-related quality of life scores and radiographic alignment were compared with nonparametric paired and independent testing (P < 0.05). Results: A total of 51 of 343 patients with ASD (14.9%) sustained a RF, of whom 44 (86.3%) had at least 6-month follow up after RF (mean age = 61.2 years, mean body mass index = 29.6 kg/m2). Mean total follow-up was 37.8 months (range 24.5-66.7 months). Interbody fusion was used in 26 cases of RF (59.1%) (transforaminal lumbar interbody fusion, n = 17 [65.4%], anterior lumbar interbody fusion, n = 5 [19.2%]). RF was symptomatic in 26 of 44 (59.1%) of patients and discovered incidentally in 18 of 44 patients (40.9%). Overall, 28 RFs were revised (63.6%); 12 of 23 (52.2%) unilateral RF and 16 of 21 (76.2%) bilateral RF at last follow-up. Revision patients were significantly more likely to be symptomatic at the time of RF detection (78.6% vs. 25.0%, P = 0.0006), and had significantly worse Oswestry Disability Index and Scoliosis Research Society-22r pain scores. Conclusions: RFs were detected in 14.9% of patients with ASD and were most common at the L4-L5 and L5-S1 levels. Approximately 63.6% of patients underwent revision surgery. The decision to perform revision surgery may be based predominantly on symptoms referable to the RF, pain, and perceived disability, as radiographic parameters at the time of RF did not differ significantly between patients who did and did not undergo revision.
AB - Objective: To report the outcome of adult spinal deformity (ASD) in patients with rod fracture (RF) after thoracolumbar fusion. Methods: Retrospective review of prospective, multicenter database. Operative patients with ASD ≥18 years old with RF after ASD surgery and with a minimum 6-month follow-up after RF were included. Health-related quality of life scores and radiographic alignment were compared with nonparametric paired and independent testing (P < 0.05). Results: A total of 51 of 343 patients with ASD (14.9%) sustained a RF, of whom 44 (86.3%) had at least 6-month follow up after RF (mean age = 61.2 years, mean body mass index = 29.6 kg/m2). Mean total follow-up was 37.8 months (range 24.5-66.7 months). Interbody fusion was used in 26 cases of RF (59.1%) (transforaminal lumbar interbody fusion, n = 17 [65.4%], anterior lumbar interbody fusion, n = 5 [19.2%]). RF was symptomatic in 26 of 44 (59.1%) of patients and discovered incidentally in 18 of 44 patients (40.9%). Overall, 28 RFs were revised (63.6%); 12 of 23 (52.2%) unilateral RF and 16 of 21 (76.2%) bilateral RF at last follow-up. Revision patients were significantly more likely to be symptomatic at the time of RF detection (78.6% vs. 25.0%, P = 0.0006), and had significantly worse Oswestry Disability Index and Scoliosis Research Society-22r pain scores. Conclusions: RFs were detected in 14.9% of patients with ASD and were most common at the L4-L5 and L5-S1 levels. Approximately 63.6% of patients underwent revision surgery. The decision to perform revision surgery may be based predominantly on symptoms referable to the RF, pain, and perceived disability, as radiographic parameters at the time of RF did not differ significantly between patients who did and did not undergo revision.
KW - Adult spinal deformity
KW - Health-related quality of life
KW - Oswestry Disability Index
KW - Pedicle subtraction osteotomy
KW - Revision
KW - Rod fracture
UR - http://www.scopus.com/inward/record.url?scp=85028337349&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028337349&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2017.07.061
DO - 10.1016/j.wneu.2017.07.061
M3 - Article
C2 - 28735127
AN - SCOPUS:85028337349
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -